MHCC Webinar on Formalized Peer Support: The Road to Recovery

Also see:

Peer Support Accreditation and Certification (Canada)

Mental Health Commission of Canada

Nova Scotia Certified Peer Specialist Program

Webcast Recording - The Nova Scotia Certified Peer Support Specialist Program by Roy Muise

National Guidelines for a Comprehensive Service System to Support Family Caregivers of Adults with Mental Health Problems and Illnesses

A report released on June 27, 2013, by the Mental Health Commission of Canada:

From this webpage:

A loved one’s mental health problem or illness often impacts family, friends and supporters. Caring for a person living with a mental illness often creates emotional, physical, financial and social burdens for caregivers. The Mental Health Commission of Canada has created guidelines for policy makers and service providers that seek to recognize and support family caregivers’ needs, including recommendations on services and supports caregivers find useful.

Please click on the image to magnify it.

To download the entire document (PDF), please click here.

Also see:

National Family Caregiving Support Guidelines

The Aspiring Workforce: Employment and Income for People with Serious Mental Illness

A report released today by the Mental Health Commission of Canada:

Please click on the image to magnify it.

To download the entire report (PDF), please click here.

Also see:

Issue: Aspiring Workforce

Case for Funding Mental Health and Social Services in Canada

Please click on the image to magnify it.

Source:

http://strategy.mentalhealthcommission.ca/about/case-for-investment

To download the entire document (PDF), please click here.

Mental-health strategy calls for complete overhaul, $4-billion commitment

An article published in today's edition of The Globe and Mail:

By André Picard — Public Health Reporter

Canada’s mental-health system is underfunded and poorly co-ordinated and needs a complete overhaul to meet the needs of patients and their families, the Mental Health Commission says in its long-awaited national strategy.

The 152-page document recommends an immediate infusion of $4-billion annually for mental-health care; calls on employers to implement psychological health and safety standards to protect workers; says efforts to divert people with severe mental-health problems out of the justice system and into care need to be accelerated; and embraces a “housing first” philosophy to get homeless people suffering from mental illness off the streets.

The Globe and Mail obtained a copy of the strategy, entitled “Changing Direction, Changing Lives,” under embargo but is publishing before the Tuesday release date because of leaks to other media outlets.

Until now, Canada has had the dubious distinction of being the only G8 country without a mental-health strategy but the Mental Health Commission of Canada says it now has a “blueprint to translate aspiration for change into action.”

An estimated 6.7 million Canadians suffer from mental illness at any given time. Last year alone, spending on mental-health services totalled $42.3-billion and the impact on the economy was even greater.

“This is an ubiquitous Canadian problem and an ubiquitous global problem,” said David Goldbloom [pictured], a psychiatrist and chairman of the MHCC. “There are significant barriers – in the health-care system, in the workplace and in the community.”

To break down those barriers – and address the problem of stigma in particular – the strategy proposes six “strategic directions” that should be pursued, and makes numerous recommendations in each area:

• Promoting mental health and prevention of mental illness;

• Fostering recovery and upholding rights;

• Providing access to the right services, treatments and supports;

• Reducing disparity and addressing diversity and those suffering mental-health problems;

• Working with first nations, Inuit and Métis, communities where addictions and suicide are major problems;

• Mobilizing leadership and fostering collaboration.

Dr. Goldbloom stressed that the commission is not a funding agency so its role is to promote a vision and promote buy-in by putting forward good research, highlighting best practices and facilitating co-operation between various stakeholders.

“We’re not an advocacy organization, we’re a catalyst,” Dr. Goldbloom said.

To underscore the approach, the strategy is peppered with examples of successful mental-health programs from around the country, such as Partners For Life, an innovative suicide prevention program that has reached 750,000 high-school students in Quebec, and the Seniors Mental Health Outreach Team that follow up on referrals from police, social services and physicians to ensure seniors with mental-health problems get follow-up care.

The strategy does not deal much with monetary issues, with one exception; it says that, currently, 7 per cent of health dollars in Canada ($14-billion) are spent on mental-health care and recommends that be increased to 9 per cent ($18-billion).

“We need more money for mental health, but we also need to spend it more wisely,” said Louise Bradley, the chief operating officer of the MHCC and a psychiatric nurse by training.

She stressed too that the needs of mental-health patients cannot be met exclusively by the health system, that changes are required in social services, education, housing and corrections.

A draft of the strategy, released in 2009, was met with sharp criticism, particularly from families of people living with severe mental illness. They complained that too little attention was paid to neuroscience and the right to treatment, and too much credence given to the civil libertarians and anti-psychiatry activists.

Dr. Goldbloom said that the final version of the strategy is very different and, in particular, pays far more attention to the needs of those with severe mental illness and their families. The report states that “treatment of people with severe illness is a gauge of system success.”

The MHCC chairman conceded, however, that it is impossible to create a blueprint for change that will please everyone. “My hope is that everyone will see they like 80 per cent of the strategy and support the overall thrust. That’s the only way we’ll be able to mobilize and move forward.”

The Mental Health Commission of Canada was created in 2007 in response to a damning Senate report on the state of mental-health care entitled “Out of the Shadows at Last – Transforming Mental Health, Mental Illness and Addiction Services in Canada.”

The MHCC has an annual budget of $15-million.

Mental Health Commission struggles to find balance in developing strategy

An article published in the October 8th edition of the National Post:

By Joseph Brean

As Senator Roméo Dallaire [pictured], Canada’s best-known traumatized soldier, launches the Lieutenant-Governor of Alberta’s Circle on Mental Health & Addiction and Queen’s University unveils its own mental health commission in response to a series of suicides, both may cast a cautionary eye on the travails of the Mental Health Commission of Canada, a 10-year, $130-million federal project.

Since a draft of its national strategy on mental health was leaked this summer, the agency has been squirming under accusations of dysfunction, anti-psychiatry bias and neglect of the most serious mental illnesses.

Critics point out the 30-page document mentions “recovery” 67 times and “support” 125 times, but there is no reference to “psychiatry.” Or “schizophrenia” or “bipolar.”

In a “letter to Canadians” last month, Louise Bradley, the agency’s chief executive, promised to “correct” the strategy before its planned release next year, because “the current draft does not sufficiently reflect the essential role neuroscience, treatment and psychiatry have to play.”

In doing so, the MHCC is trying to strike a balance between the two major ideologies of mental health: empowerment, based in social science, in which recovery is seen as a personal growth experience; and psychiatry, based in neuroscience, in which recovery sometimes must be imposed against a delusional will.

At its most extreme, this clash of ideologies turns on the question of whether the fundamental problem of mental illness lies in the brain itself, or in the stigma imposed by society.

At stake is a key part of the MHCC’s dual mandate — to develop a national strategy on mental health — which will influence the allocation of research funding and the priorities provinces set on this unique issue, spanning health care and social policy.

The other part of its mandate is to combat the stigma of mental illness through public outreach and professional advocacy, which have largely focused on health-care providers, often the first point of contact between the mentally ill and the government.

As the strategy gets revised, the ideological balance continues to elude the MHCC, although a spokesman said the flawed draft is “relatively close,” and the Commission stands by it “fundamentally.”

Focused on “recovery,” the draft strategy highlights suicide prevention, self-directed care, improvement over cure, and calls for an end to the seclusion and restraint of psychiatric patients.

However, its focus on health promotion and prevention, including the role of employers in creating healthy workplaces, has fuelled criticism that this is not a strategy about mental illness, but rather mental wellness.

“They’ve stolen the word ‘recovery,’ ” said Herschel Hardin, president of the North Shore Schizophrenia Society in B.C., whose latest bulletin accuses the commission of hiding behind upbeat euphemisms and claims “those who understand severe mental illness no longer take [the MHCC] seriously — except to regard it as a menace.”

He said the agency exaggerates the notion recovery cannot be imposed by others and must be a self-directed personal achievement.

“For the seriously ill, that’s a small part of recovery that comes after treatment for the illness itself, which is part of recovery, which requires a lot of not just support but structure, provided by others,” he said.

“Here [at the MHCC] we have a bunch of people who really haven’t done the homework that they had to do, and buried the most important considerations in bureaucratic fluff and vague wording.”

More than most health issues, vocabulary clouds this debate.

Patients are recast as “survivors,” “consumers,” or “experts by experience” on the one side, and a schizophrenic’s lack of insight medicalized into “anosognosia” on the other.

“The idea of recovery in mental illness circles has a certain meaning that is not translated well for the general public,” said Bill Honer, head of the department of psychiatry at the University of British Columbia and a clinical expert on schizophrenia.

It is not like remission in cancer, in which the disease metaphorically retreats, or recovery from a cold, in which it disappears completely. Recovery in mental health, as the MHCC describes it, is an orientation, a way of life.

The danger, Prof. Honer said, is that a strategy in which individuals must guide themselves to recovery could be unfair to those who are unable to do so, because they cannot understand their own illness.

“On a strict interpretation [of that strategy], we risk not fulfilling our social responsibilities,” he said.

At the same time, there is rampant confusion about these words and what they imply, he said. “The social constructs of labelling and diagnosis are real, but it’s not the same as what we do [in psychiatry]. Having a diagnosis is not a bad thing. That’s how we work. But labelling and stigma are, and that’s how society works.”

Ms. Bradley refused to be interviewed, but strategic advisor Howard Chodos, who prepared the draft strategy, said it was developed through face-to-face meetings and an online survey.

The “vast majority” of participants in consultations were “supportive of the overall thrust of the strategy,” he said, but the review process now includes “some of more public discussion that’s taken place once the draft reached a wider audience than we originally intended.”

“Was everybody included? No. Did we have the resources to do that at this time? No,” he added.

“But we felt confident that we would get the kind of feedback from that group that would enable us to strengthen the document.”

Mr. Chodos acknowledged the criticism and said the draft’s language “is not where we would like it to be, in terms of connecting with people, resonating with people in a way that will help to galvanize support for the document.”

But he rejects the notion that the focus on consensus obscures the hard cases.

“What I don’t accept is that there is a fundamental opposition between those two elements,” he said.

“We can find a way to have that balance, and we’re not sacrificing one on the altar of the other.”

jbrean@nationalpost.com

Image credit

Also see:

Mental Illness Awareness Week: Canada Stands Ready for Positive Change

Michael Kimber at the University of King's College media symposium

From the YouTube posting by the Mental Health Commission of Canada:

Michael Kimber, a King's College graduate, speaks about his personal experience with mental illness at the King's College media symposium.

Michael Kimber suffers from intense anxiety and isn't afraid to tell anyone. He writes about his experience in a personal, heart-felt and riveting blog and receives thousands of hits daily. Today Michael is still blogging, writing a book, and continuing to attract attention on the impact of stigma and mental health.

Mental health strategy draft doesn’t go far enough

An article published in today's edition of The Globe and Mail:

By André Picard (pictured)

Copies of the “confidential” draft of Canada’s highly anticipated mental health strategy are circulating widely among “targeted stakeholders.” So let’s take a look at what’s being offered up.

Canada is the only G8 country without a mental health strategy, so the document – and, more important, the underlying philosophy that we need to make life better for those with psychiatric and psychological illnesses – is long overdue.

After all, one in five Canadians will suffer a bout of mental illness; it is the principal cause of absenteeism and disability, and costs the economy a staggering $51-billion annually.

A strategy is essentially a way of setting priorities, of ensuring that no group is overlooked or neglected, that services are co-ordinated and that voices are heard in the corridors of power.

The Mental Health Commission of Canada, whose role it is to draft and implement the strategy, more or less has its priorities right, as evidenced by its six “strategic directions”:

1. Shift upstream and across sectors. This means emphasize the promotion of mental health (not merely the absence of mental illness), intervene early when people are sick – at school, at work or wherever – and tackle the stigma of mental illness.
2. Transform relationships and uphold rights. The draft document emphasizes recovery (most, but not all, people with psychiatric illnesses get better) and the need to get the sick out of the criminal justice system.
3. Strengthen capacity in the community. The strategy calls for a shift to community-based care and underscores the importance of housing and income support to aid the recovery of those with mental illnesses. 
4. Improve equity. Access to mental health services varies markedly across the country and among various age groups (with access to care for children being particularly abysmal), and the gaps need to be closed. 
5. Seek innovation with first nations, Inuit and Métis. Some communities, such as aboriginals, have specific challenges like sky-high rates of addiction and suicide that need particular attention. 
6. Mobilize leadership. The strategy calls for a “whole of government” approach, meaning mental health is not strictly a health issue – it affects the workplace, housing, justice and so on. The draft also calls for a strengthening of the mental health infrastructure.

The commission and the strategy have their genesis in a landmark 2006 Senate report entitled Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. The 567-page report was thoughtful, reasoned, forward-looking and, sometimes, even bold in describing the shortcomings of mental health treatment, dubbed the orphan of the health system, and in proposing solutions.

The committee, headed by then-senator Michael Kirby (who now heads the MHCC), made 118 recommendations, most of which find echo in the new document.

But there are some subtle, yet important differences between the tone and content of Out of the Shadows at Last and the draft strategy.

First, the language is more bureaucratic and wishy-washy. Mr. Kirby and his senatorial colleagues were refreshingly blunt on what needed to be done; the anonymous drafters of the strategy are far more circumspect.

Far more troublesome is what you can read between the lines of the proposed strategy. There is far too much emphasis on the “recovery model” – the notion that everyone will get better with support – and not enough emphasis on brain science. It’s a legitimate approach for those with mild and moderate mental health problems but not those with severe conditions such as schizophrenia.

In fact, reading the draft strategy, one is left with an unpleasant aftertaste: the distinct feeling that psychiatry and medications have no place in Canada’s approach to tackling mental illness.

There are distinct – and sometimes clashing – views in the mental health field. But the strategy gives too much credence to social science and not enough to neuroscience.

It also pays far too much attention to the views of “psychiatric survivors” who hide their vehemently anti-treatment views in the promotion of “peer support” and the language of “rights.”

But hope – and false hope – cannot be allowed to take the place of care. Where in the strategy, for example, is the call for investment in brain research, psychiatric beds and more addiction treatment facilities?

The draft also gives short shrift to the sickest of the sick, those with severe (and often intractable) cases of schizophrenia and bipolar disorder, who often suffer from anosognosia (where people don’t even recognize they have a mental illness).

This group, while small (less than 1 per cent of those with mental illness), are those who populate our streets and prisons. They don’t need the right to refuse treatment, they need the right to be well. And their families need to be empowered to help them, not cast aside.

Susan Inman, author of the memoir After her Brain Broke: Helping my Daughter Recover her Sanity, offers up a detailed critique of the strategy’s shortcomings in this regard in her article Suppressing Schizophrenia, published this week by The Tyee.

One of the MHCC’s key goals has been to help create a social movement, one that empowers people living (or having recovered from) mental illness. This is how women with breast cancer, men with prostate cancer and people living with HIV-AIDS have brought their issues to the forefront and made great strides.

But the mental health movement has to learn an important lesson from these other movements: You have to be inclusive, you have to embrace science, you have to be mainstream and you cannot allow those with ulterior motives to set the agenda.

There is a lot of good in Canada’s draft mental health strategy. But it’s not good enough yet.

Also see:

An open letter to Canadians from the Mental Health Commission of Canada

North Shore Schizophrenia Society Advocacy Bulletin (September 2011)

Suppressing Schizophrenia

An article posted yesterday by TheTyee.ca:

Schizophrenia is invisible in Canada's new mental health strategy.

By Susan Inman (pictured)

It is hard to imagine that life could get any harder for individuals living with schizophrenia (one per cent of the population) and the families who provide support to them. However, the controversial choices made by the Mental Health Commission of Canada (MHCC), in the latest draft of the new Mental Health Strategy, make it likely that their situations can actually get worse. These choices, which were not apparent in any earlier MHCC documents, are not receiving the public scrutiny that is needed because this draft is not available for the public. This draft, which was shared with a very small number of people, is currently being polished, and the Canadian public will not see it until it is unveiled in early 2012.

Through both what the strategy suggests and what it fails to support, this plan represents decisions that are dangerous to the well being of people with schizophrenia.

None of the MHCC documents have provided even the most basic information about this often misunderstood mental illness. For instance, the public has never learned that 40 to 50 per cent of psychotic people don't understand that they are ill and so have no reason to ask for or consent to treatment. Nor does any of the educational material promoted by the MHCC in its Mental Health First Aid program mention that 90 per cent of people with schizophrenia who stop taking their medications will have a relapse. A clearer understanding of this neurobiological disorder can help people understand the mental health policies that are most appropriate.

One major problem with the strategy is its approach to legal issues. The new draft strategy promises funds for court challenges to human rights abuses. The public deserves to have open access to this document to find out exactly what the MHCC intends with this action. Since the MHCC has allied itself with groups opposed to involuntary treatment of psychotic people, it is likely that federal funds could be made available to challenge involuntary treatment orders that have been made under various provincial mental health acts. Some human rights activists insist that no one should be treated for psychosis unless they choose this option; however, the notion of choice does not make sense in this context because people experiencing a profound psychosis do not have access to their rational thinking processes. They are not able to act in their own best interest, which is why mentally ill people frequently end up homeless or, increasingly, in prison.

To read the entire article, please click here.

Photo credit

Also see:

Mental Health Strategy for Canada - DRAFT (June 3, 2011)

Mental Health Commission of Canada - 2010/2011 Annual Report

Please click on the image to magnify it.

An email from the Mental Health Commission of Canada which the SSNS received today:

Hello,

On behalf of the Mental Health Commission of Canada (MHCC) I am pleased to present the English and French versions of our 2010-2011 interactive annual report.

Together we can. It is our theme this year because our accomplishments are due in large part to collaboration with a wide variety of individuals, groups and organizations. Alongside our partners we worked to promote mental health, reduce stigma and improve services and supports. With our hundreds of partners, we are helping to make mental health a priority for all Canadians.

MHCC Annual Report

Our Annual Report outlines the significant progress we have made towards achieving our goals. Among other updates, readers will learn that we have now housed hundreds of people in five Canadian cities through At Home/Chez Soi – our national research project on mental health and homelessness. We have now trained over 20,000 people across the country in Mental Health First Aid. This represents an increase of over 100% since it became an official MHCC program in 2010. These are just two milestones made possible through support from the Government of Canada.

I hope you will find this document engaging and informative and will enjoy flipping through its pages. Please forward it along to your colleagues, friends and families. I look forward to your feedback.

Yours sincerely,

Louise Bradley
President and Chief Executive Officer

To download the PDF version of the MHCC Annual Report, please click here.

Overview - Mental Health Commission of Canada

Overview of the Mental Health Commission of Canada as posted on LinkedIn:

People living with mental illness have the right to obtain the services and supports they need. They have the right to be treated with the same dignity and respect as we accord everyone struggling to recover from any form of illness.

The goal of the Mental Health Commission of Canada is to help bring into being an integrated mental health system that places people living with mental illness at its centre.

To this end, the Commission encourages cooperation and collaboration among governments, mental health service providers, employers, the scientific and research communities, as well as Canadians living with mental illness, their families and caregivers.

The organization of publicly funded mental health services and supports to the general population is the responsibility of each provincial and territorial government, not of the Commission.

The Mental Health Commission of Canada will:

• Be a catalyst for the reform of mental health policies and improvements in service delivery;

• Act as a facilitator, enabler and supporter of a national approach to mental health issues;

• Work to diminish the stigma and discrimination faced by Canadians living with mental illness;

• Disseminate evidence based information on all aspects of mental health and mental illness to governments, stakeholders and the public.

United front on mentally ill urged

An article published in the July 19th edition of the National Post:

By Joseph Brean

Canada needs a "dynamic, broadly based social movement" to improve its citizens' mental health, a "whole of government" approach that unites everyone from political leaders to "experts by experience," says a national strategy five years in the making.

The goal, says the Mental Health Commission of Canada (MHCC), should be a "cultural shift toward recovery," which favours real improvement over ideal cure, and is informed by "multiple sources of knowledge," including the traditions of restorative justice and the hard-won wisdom of people in recovery.

The 37-page draft strategy document, obtained by the National Post, also seeks to reduce the stigma of suicide; calls for an end to "seclusion and restraint" of psychiatric patients; and demands that, in criminal-record checks, police stop disclosing information about people they have driven to hospital in a mental health crisis.

"This practice inhibits people's ability to volunteer or get a job, and should be stopped," reads the report, Mental Health Strategy for Canada - Draft, Not For Circulation. A final version is expected to be presented to the MHCC's board in October, and released publicly next year.

The strategy acknowledges the federal government's arm's-length role in healthcare delivery, but argues that mental health is not purely a health issue, as it also involves criminal justice, housing, finance and child services. The MHCC's broad solution is to "shift upstream and across sectors" by taking a "whole of government" approach, in which actions are nationally co-ordinated, and "leadership [is] located at the highest level possible within government and the bureaucracy."

Clinically, the strategy calls for a "genuine partnership" between caregivers and people with mental illnesses, who should be offered "self-directed care-funding initiatives," so they can "directly manage part of their social service and health budgets."

"The expertise gained from lived experience should be complemented by professional expertise, not dominated by it," the report reads.

"Not only will this change in the distribution of power within the mental-health system benefit users of services, it will also create a more positive context in which mental health providers can deploy their skills, experience and knowledge."

Examples of self-directed care choices might include art or music therapy, or training in mindfulness techniques, said Howard Chodos [pictured], special advisor to the MHCC.

Finding the right balance, he said, "involves the skill and art of medicine as much as it does the science.

"Unfortunately, in mental health there are no blood tests and there are no medical tests which tell you what illness you have and what treatment to use," he said.

The strategy also calls for better training for so-called "gatekeepers" - teachers, doctors, clergy, police and prison staff - to help them recognize and react to warning signs of suicide, and to promote mental health.

This focus on prevention and health promotion is a target of early critics of the report, who say it offers little to people with serious mental illnesses, such as schizophrenia or bipolar disorder, which cannot be prevented by social policy, as they are organic diseases of the brain.

They cite New York State's Office of Mental Health as a cautionary tale of a system in which the "worried well" gained support at the expense of the truly sick.

Susan Inman, a Vancouver advocate for the families of people with serious mental illnesses, whose daughter recovered from schizophrenia, said the strategy's deference to lived experience will make things worse for people who are so mentally ill they are incapable of realizing it - a condition known as anosognosia. She fears the emphasis on personal empowerment will make involuntary treatment almost impossible.

"This plan is really about mental wellness," she said. "People with serious mental illnesses are ignored."

Mr. Chodos said research shows a range of factors can increase or decrease the risk of even the most serious mental illnesses.

"We do not yet know that there is anything more than a genetic predisposition," he said.

"Prevention [in the strategy] is not only prevention of onset, but also the debilitating consequences of it."

He gave the example of homelessness, often associated with schizophrenia and substance abuse, as an area where social policy can, in fact, prevent the worst of a mental illness.

He said another is cannabis use among youth, a known risk factor for schizophrenia.

The MHCC, which was established in 2007 by Prime Minister Stephen Harper on the recommendations of former Senator Michael Kirby, has a twin mission. Erasing stigma has always been the long-term goal, but this formalized national strategy is the immediate plan.

The strategy comes at a crucial moment for psychiatry, not just in Canada but globally, as the discipline's diagnostic manual undergoes a thorough revision.

There is also a strong climate of suspicion about the role of drug manufacturers in the proliferation of psychiatric drugs, and about the spike in diagnoses of childhood behavioural disorders.

jbrean@nationalpost.com

Image credit

Also see:

An open letter to the Mental Health Commission of Canada - A response to their draft Mental Health Strategy for Canada

Identification of a biological signature for schizophrenia in [blood] serum

A 12-Step Program For Canada

Serious Mental Illness, Care-Giver Stress and the Mental Health Commission of Canada

An article posted on June 24th by Huffpost Canada:

By Marvin Ross

Caring for a family member with a serious mental illness (mainly schizophrenia and bipolar disorder) is often extremely stressful for families; it impacts them financially, emotionally, socially and physically.

Hoping to improve the situations for the tens of thousands of families in this situation, a group of 45 B.C. families sent suggestions to the Mental Health Commission of Canada with the hope that the Commission would adopt them and help support families. Their suggestions were sent via e-mail and were widely distributed.

The Commission had previously stated they wanted to hear from stakeholders. But, Susan Inman [pictured], a Vancouver teacher, writer and parent said in an e-mail to me, "We didn't feel very reassured" that they are listening. "We are still hoping that Ms. Bradley will respond to our suggestions."

Ms. Inman is the unofficial group spokesperson and Louise Bradley is chair and CEO of the commission.

The commission defines itself as "a catalyst for transformative change" with the goal to, among other things, "improve services and support." The organization arose from the report Out of the Shadows at Last -- Transforming Mental Health, Mental Illness and Addiction Services in Canada in 2006. It received federal funding in 2007.

Ms. Inman further stated in her e-mail:

"I don't think that family caregivers for people with psychotic disorders are feeling hopeful when we see the limited agenda promoted by the Family Caregivers Advisory Committee (FCAC) on the Mental Health Commission of Canada's website. The group pointed out that the only research project the FCAC listed, a family mutual assistance strategy, has already been well researched in BC.

The group also pointed out that, by selecting this as their one project, the FCAC is communicating that "the message that what is most important is for caregivers to just learn how to take better care of each other. Meeting the needs of family caregivers involves much more careful examination of many systemic issues."

One suggestion is to research the quantity and nature of family care-giving for people with serious mental illnesses and to estimate the value of the unpaid family labour in terms of decreasing health care costs. The group also believes that the Commission should advocate to raise the standards of programs training mental health professionals to include science based approaches to understanding severe mental illnesses. Many professionals are not knowledgeable about advances in brain research and often still believe that families cause these mental illnesses. Inadequately trained mental health professionals aren't equipped to refer to early intervention programs -- a new best practice being implemented across the country. The group would like to see more collaboration between families and professionals.

One area of growing scientific understanding is of anosognosia -- the neurologically based inability of someone who is ill to understand that they are ill. Research shows that 40 to 50 per cent of people in the grip of a psychosis suffer this and it often results in treatment refusal.

Family caregivers wish to see the Commission recognize this problem and to recognize the need, at times, for involuntary treatment. Many have ill relatives who look to their families to ensure that they are not left untreated and allowed to deteriorate in case of a relapse. Families need help to gain access to legal means to be able to fulfil this responsibility.

Parents often still continue to experience the destructive impact of unjustified blame for these disorders -- a holdover from the non-research based and unscientific theories that dominated psychiatry and psychology in the past. These parents would like to see the Commission openly acknowledge and address this.

Finally, the language in Commission documents suggests that severe and persistent mental illnesses, like other mental health concerns, may be caused by adverse social circumstances. The Commission should openly support a science based understanding of these neurobiological disorders. As well, it should actively promote the brain based research that can lead to better treatments and, ultimately, cures. Currently, on the Commission's Science Advisory Committee site, there are no proposals for encouraging ongoing scientific investigation of any kind of mental illness.

The group has yet to hear from Ms. Bradley. They did receive a response from Ella Amir, Chair, Family Caregivers Advisory Committee (FCAC). She stated in her e-mail reply to the group, "One of the projects the FCAC has proposed focuses on the same concerns you describe... if approved, this proposed project will address yours (and our) concerns," Since Ms. Amir didn't describe any of the proposed projects, Ms. Inman didn't feel reassured that the FCAC is moving in the right direction.

Ms Amir did add that she was sure that Ms Bradley would also reply. When contacted, Kyle Marr, a spokesperson for the Commission, said he understood their concerns about not having any reply yet but "due to the depth of the email and the issues that it addressed, careful consideration is required".


Follow Marvin Ross on Twitter: www.twitter.com/dysdads

Photo credit

Mental Health Commission of Canada Peer Project

An email received on June 8th from the Mental Health Commission of Canada's Peer Project Team Leader (pictured):

Subject: Communiqué about the Peer Project – Mental Health Commission of Canada (MHCC)

Following the April 2011 Peer Project update, many of you expressed interest in participating in a Webinar session to discuss how to preserve the natural, organic way in which grass-roots peer support has functioned, as we develop a certification process for peer support.

We decided to consult members of the Peer community to help plan for this event. During our discussions, we talked about the format of the Webinar, possible panelists were identified and the most beneficial means for participants to have an open discussion was determined.

It was important for us to organize this Webinar in a way where the issue was treated in a responsible and respectful manner. It was clear from the two groups we engaged with that panelists should rapidly present varying views on the issue but that the majority of the time allocated for this Webinar be at the disposal of participants, allowing a healthy dialog to take place.

We invite you to participate in one of the following events:

• Tuesday June 28th at 1:00pm EST

• Wednesday June 29th at 1:00pm EST

The Webinar will be structured with two panelists each presenting views on the issue for 10 minutes followed by a 40 minute moderated discussion where all participants will be invited to the dialogue. Both sessions will be organised in the same fashion and host the same panelists and the presentations during each session will be the same. Following the sessions, participants will have access to the content of both Webinars and have the opportunity to provide further input.

Our panelists:

Joan Edwards-Karmazyn, Executive Director with the National Network for Mental Health;

Diana Capponi, Employment Works Coordinator for Center for Addictions and Mental Health; and

John Massam, Peer Support Program Coordinator, Coast Mental Health.

Our moderator:

Karen Liberman, Executive Director, Mood Disorders Association of Ontario

* Biographies of the panelists will follow shortly

At this time, we request that you sign-up for one of the webinar sessions by Friday, June 24th. In order to ensure maximum participation and entertain a good dialogue, we will host 20 people per Webinar and we are prepared to hold additional Webinars if required, to accommodate all participants. Please indicate clearly which session you would like to attend.

Joining instructions, panelist and moderator biographies will follow shortly.

Thank you very much for your interest in participating in this very important part of the process.

Image credit

Mental Health Commission of Canada praises investments in mental Health by New Brunswick and Newfoundland and Labrador

A media release issued today by the Mental Health Commission of Canada:

CALGARY, May 5 /CNW/ - The Mental Health Commission of Canada (MHCC) is applauding the provinces of New Brunswick and Newfoundland and Labrador for their recent commitments to mental health. "I am so pleased to learn of these announcements," said Louise Bradley, MHCC President and CEO. "These commitments reflect the important steps taken by several provinces to transform their approach to mental health," she said.

New Brunswick has released a new action plan for mental health, with a vision for all New Brunswickers to have the opportunity to achieve the best possible mental health and well-being. The plan includes a range of initiatives such as the introduction of recovery-oriented treatment teams in communities across the province, cultural safety training and the promotion of mental fitness and resiliency early in life. The MHCC had the opportunity to participate in the province's Mental Health Strategy Advisory Committee alongside New Brunswick stakeholders. (Read the New Brunswick action plan at http://www.gnb.ca/0055/pdf/2011/7379%20english.pdf)

In its latest budget, Newfoundland and Labrador has committed 8.7 million dollars to mental health initiatives, including an awareness campaign to fight stigma, an e-mental health program and peer support. MHCC President and CEO Louise Bradley welcomed the chance to participate in discussions with Newfoundland and Labrador's Provincial Mental Health and Addictions Advisory Council related to the province's mental health planning. "I look forward to working with the Council on an ongoing basis," Bradley said. (Read the Newfoundland and Labrador budget details at: http://www.budget.gov.nl.ca/budget2011/default.htm)

The MHCC is currently developing a mental health strategy for Canada and continues to work directly with provinces and territories on the details. (For more on the MHCC strategy, please visit http://www.mentalhealthcommission.ca/English/Pages/Strategy.aspx)

The Mental Health Commission of Canada is a catalyst for transformative change. Our mission is to work with stakeholders to change the attitudes of Canadians toward mental health problems and to improve services and support. Our goal is to promote mental health and help people who live with mental health problems lead meaningful and productive lives. The Mental Health Commission of Canada is funded by Health Canada. For more, visit www.mentalhealthcommission.ca

The views represented herein solely represent the views of the Mental Health Commission of Canada.

Production of this document is made possible through a financial contribution from Health Canada.

For further information:

Nujma Bond, MHCC Communications, 403-385-4033

Mental health system 'fragmented'

An article published in today's edition of The Chronicle Herald:

Canada lacks strategy, public forum told

By John McPhee, Health Reporter

Canada is the only G8 country that doesn’t have a national mental health strategy, a public forum was told Monday.

In fact, it would be a stretch to say we have a mental health system at all, said Louise Bradley (pictured), president and chief executive officer of the Mental Health Commission of Canada.

"It’s too fragmented to be called a system," Bradley told more than 250 people who packed two large rooms in the Halifax Forum complex for the forum.

The commission, made up of 50 staff members and 120 volunteers, was created three years ago as a result of the Kirby report on mental health and addiction in 2006. It was given a 10-year mandate to address such issues as homelessness, stigma and mental health "first aid," which seeks to identify and address problems as early as possible.

But it is up to grassroots organizations and the provinces to make the commission’s plan a reality, said Bradley, the former head of mental health services at the Capital district health authority.

"If we have no ability to implement anything, it’s going to be a waste of time and a waste of money."

The forum was jointly sponsored by Dalhousie University’s psychiatry department and the Mental Health Coalition of Nova Scotia, made up of individuals and organizations focused on addressing mental health issues.

The province puts about 3.8 per cent of roughly $3.5 billion in health spending into mental health services.

"The system has to work, the capacity has to be built up," Nick Delva, the head of the Dalhousie psychiatry department and co-leader of Capital Health mental health services, said in an interview.

"I don’t think that’s occurring right now. Many people aren’t getting care."

Delva spoke at the forum along with other care providers and advocates from the province and Capital Health.

He singled out the need for housing and treatment in the community for people dealing with complex problems.

"Any particular day here (in Capital Health), we have 50 to 70 people in our in-patient beds who could be placed in the community if there were adequate support."

During question-and-answer sessions, Delva and other speakers heard criticism about access to mental health services, particularly in rural areas.

"There’s plenty of mental health services, but there’s no way people can access them," said Randy Carter of East Jeddore, Halifax County, who noted the lack of public transportation outside of urban centres.

"Something has seriously got to be done because I’ve been involved in this for 40 years and it’s still the same as it was back then."

Collaboration among all government levels are crucial to addressing these kinds of problems, said Susan Kilbride Roper, the co-chairwoman of the mental health coalition.

She particularly welcomed the national commission’s work and that of the Nova Scotia mental health strategy advisory committee.

"We’ve got a bunch of advocates, federal advocates, we’ve never had that before," Kilbride Roper said in an interview. "This is the good news. Getting back to the bad news, the issues are still there and they’re becoming increasingly (serious). Hospital wait times, services in the community, there’s not enough funding. Provincially, we have a lot more work to do."

(jmcphee@herald.ca)

Image credit

Mental Health Commission of Canada - Winter 2011 Newsletter

Please click to image to magnify it.

To view the entire newsletter, please click here (PDF).

Old Vancouver motor hotel gets new life as part of homelessness experiment

An article published in yesterday's edition of The Vancouver Sun:

By Todd Coyne

Downtown Vancouver’s old Bosman’s Motor Hotel is once again filling up fast. Not with the road-weary travellers of earlier days, however, but with people whose paths in life have led them, wearily, to the streets.

Now renamed the Bosman Hotel Community, the four-storey former inn at 1060 Howe St. officially opened its doors Monday as the Vancouver site of a five-city federal research project studying the relationship between homelessness, mental illness and addiction.

With similar facilities in Winnipeg, Toronto, Montreal and Moncton, the Mental Health Commission of Canada is studying the effects of a “Housing First” approach to treating the mental health problems of chronically homeless people in Vancouver. This model means providing suitable candidates with housing and food as a first priority before trying to address their mental-health problems and their goals for recovery.

Inside the Bosman, the rooms are small and bear all the furnishings immediately familiar to anyone who’s ever stayed in low-cost, continental breakfast-included lodgings anywhere in North America. There’s a heavy-blanketed bed, a lamp, a bathroom on the left and even a Bible in the nightstand.

For a hundred of Vancouver’s hardest to house, it will be home.




“If it was not for this place, I do believe I would not be here today,” said new Bosman resident Nicola Keate [pictured].

In front of a crowd of city politicians, university researchers and homeless-outreach workers in the Bosman’s cramped main room, Keate told of how at age 14 she started using drugs and immediately became hooked.

Later, she found out she had a bipolar disorder — which, she said, led to more drugs and a life of crime.

It’s a cyclical refrain among the Bosman’s 67 residents — drugs leading to illness leading to drugs — and one which the federal mental health commission, in association with the Portland Hotel Society in Vancouver, is trying to end in the homeless population nationwide.

Jeff West, the Bosman’s project manager, said that 500 of Vancouver’s homeless with addictions and mental health problems were selected as potential candidates for residency at the Bosman Hotel. One hundred of them were then offered residency at the Bosman — something one resident compared to winning the lottery — for a maximum stay of three years.

That’s when the national study ends and when West said the Bosman Hotel’s owners, Prima Properties Ltd., plan to build condominiums.

Of the other 400 study participants in the city who will not be moving into the Bosman, 200 will not receive housing as the study’s “treatment as usual” control group, and 200 will be put into “scatter housing” around the city and connected to case managers and mental health support workers, West said. Nationwide, 2,285 people are participating in the three-year “At Home” study; of these, 1,325 will receive housing.

tcoyne@vancouversun.com

Photo credit

CMA awards Medal of Honour to the Honourable Michael Kirby

An August 11th media release from the Canadian Medical Association:

Ottawa, August 11, 2010 - The Canadian Medical Association (CMA) will present the 2010 CMA Medal of Honour to the Honourable Michael Kirby, who has demonstrated outstanding public commitment to raising awareness of mental health issues and diminishing the stigma and discrimination faced by Canadians living with mental illness.

“The CMA Medal of Honour recognizes personal contributions to advancing medical research and education,” said CMA President Dr. Anne Doig. “Mr. Kirby [pictured] has worked diligently to bring awareness to the mental health issue.”

Mr. Kirby is well known to physicians for his landmark Senate reports on health care reform. Now retired from the Senate of Canada after 22 years of service, Mr. Kirby chairs the Mental Health Commission of Canada where he has demonstrated the same outstanding public commitment – this time, to raising awareness of mental health issues and diminishing the stigma and discrimination faced by Canadians living with mental illness.

“I have been privileged to have worked on major Canadian public policy issues for more than forty years. In that time, nothing has been more gratifying than my work on health care in general and mental health care in particular,” said Mr. Kirby. “I believe that, with the help of all Canadians, it will be possible to substantially reduce the stigma and discrimination faced by people living with a mental illness, and to put in place a system of services and support that will enable them to lead a much more satisfying and productive life.”

Mr. Kirby’s personal interest in health care delivery was evident during his seven-year term (1999–2006) as chair of the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s focus was to develop a federal health policy that would support a financially sustainable health care system over the long term.

The committee published six reports on health care, culminating with Recommendations for Reform, in 2002. The report included numerous and varied recommendations: the need for better accountability through an annual report on the health care system and the health status of Canadians; the need for improved efficiency measures, including primary care reform; the need for timely access to health care in the form of health care guarantees; and the need to close gaps in the safety net by expanding coverage for catastrophic drug costs, and acute and palliative home care.

Following publication of the report, the Social Affairs Committee, chaired by then-Senator Kirby, turned its attention to the issue of mental health, mental illness and addiction. The committee published three background reports in 2004 and its final report, Out of the Shadows At Last, was released in 2006. One of the principal recommendations of this report was that the federal, provincial and territorial governments should establish the Mental Health Commission of Canada.

Mr. Kirby retired from the Senate in 2006 and was appointed chair of the newly created Mental Health Commission of Canada in 2007. The commission’s mandate is to develop Canada’s first national mental health strategy and to launch a decade-long, anti-stigma program to change public attitudes and behaviour toward people living with mental illness.

While the goals of the Mental Health Commission are certainly no small challenge, Mr. Kirby has a proven track record of successfully developing and implementing public policy for governments and the private sector. He served as principal assistant to Premier Gerald Regan of Nova Scotia (1970–73), assistant principal secretary to Prime Minister Pierre Trudeau (1974–76) and president of the Institute for Research on Public Policy (1977–80). While he was Secretary to the Cabinet for Federal-Provincial Relations and Deputy Clerk of the Privy Council (1980–83), he was the senior public servant involved in the negotiations that led to the patriation of the Canadian Constitution and inclusion of the Charter of Rights in the constitution.

He has been a professor at Dalhousie University, has taught at the University of Chicago and University of Kent, has served on the boards of numerous public companies, is a regular media commentator on public policy issues, and is a featured speaker at many national conferences.

In recognition of a lifetime of outstanding achievement on major public policy issues and his current commitment to confronting the challenges related to mental illness, Mr. Kirby was appointed an Officer of the Order of Canada in 2008.

The Honourable Michael Kirby is the 27th recipient of the CMA Medal of Honour, the highest award bestowed upon a person who is not a member of the medical profession. He will receive this award at a special ceremony at the Crowne Plaza Hotel, in Niagara Falls, Ont., on Aug. 25 as part of the CMA’s 143rd annual meeting.


For more information:

Lucie Boileau, Manager, Media Relations
Tel.: (613) 731-8610 or 800-663-7336 ext. 1266
Mobile : (613) 447-0866
lucie.boileau@cma.ca

Photo credit

Peer Project - Mental Health Commission of Canada

A posting on the Mental Health Commission of Canada's website:

The Mental Health Commission of Canada has launched the Peer Project to enhance the utilization of peer support through the creation and application of national standards of practice. It is also designed to encourage a change in societal attitudes towards mental illnesses through peer based education strategies specifically targeting youth in schools and adults in workplaces. The project supports and shares in common a number of the objectives related to key initiatives and other projects of the Commission and its advisory committees.

The use of peer based approaches is founded on the belief that people who have faced, endured, and overcome the adversity of mental health conditions can offer beneficial support, encouragement and hope to others facing similar situations. Peer based services, i.e., peer support delivered in conjunction with mental health education delivered by peers can greatly enable Canadians to better understand and accept the realities of mental health challenges, leading to a more supportive society.

It is recognized that there are valuable and effective variations regarding the way peer support is provided in Canada and a “one size fits all” approach is not what the peer project intends to develop. A chief concern is to not lose sight of the grass roots, community based practices that have characterized the success of this type of mental health intervention.

The Mental Health Commission believes, however, that before organizations of different types and sizes are willing to further invest in peer based initiatives, evidence-based frameworks will need to be developed. The literature on peer based services in Canada and other countries suggests that the lack of adequate empirical evidence supporting the effectiveness of peer delivered interventions has impeded their growth and wider-scale use. Consequently, the design of both project components will be underpinned from the very outset with performance measurement and evaluation strategies.

Developing standards of practice will provide frameworks to enhance the credibility of peer based services. Standards of practice are established by identifying the competencies, experience, training/education, and values, which together constitute the hallmark for providing effective services.

Obtaining the views and input of stakeholders is a prominent feature of this project, particularly in relation to the peer support component at this stage. The Project Team is currently planning a comprehensive consultation process with the initial goal to develop standards of practice for peer support that will be implemented and tested beginning with workplaces.

As the Peer Project evolves, updates will be posted to the web site to allow interested parties to follow the development of this endeavour.

Also see:

Definition of ‘Peer’

Peer Project Outline

Tell us about yourself